[Clinical evaluation, evolution and intensive care treatment of severe acute pancreatitis]

Severe acute pancreatitis is morphologically characterized by an intense and necrotizing inflammatory process responsible for early remote organ dysfunctions and late regional complications. Retroperitoneal necrosis has to be identified early by several biological markers and abdominal CT study. A better understanding of the pathophysiological mechanisms underlying the natural history of severe acute pancreatitis, progress in intensive care support and the emergence of new conservative or surgical strategies aimed at removing the necrotic areas and their toxic by-products have led to a dramatic reduction in early and overall mortality for the patient with this disease.